Effect of Chronic Noise Exposure on Psychological and Physiological Indicators in Patients with Rheumatoid Arthritis

This study was designed to assess the effect of chronic noise exposure on psychological and physiological indicators in patients with rheumatoid arthritis (RA).

A cross-sectional study was conducted on the data of 304 patients diagnosed with RA at Changsha Traditional Chinese Medicine Hospital (Changsha Eighth Hospital) from June 2020 to June 2023. Patients were categorised into a low-noise (LN) group [<60 dB(A)] and a high-noise (HN) group [≥60 dB(A)] on the basis of the average noise exposure level, and they underwent propensity score matching (PSM). The collected data included demographic information, A-weighted equivalent continuous sound level (LAeq, 8 h), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Self-Esteem Scale (SES), Disease Activity Score 28 (DAS28), clinical symptoms and inflammatory markers.

After PSM was conducted, 102 patients per group with balanced demographics were included. The LAeq was 66.28 ± 2.35 dB(A) in the HN group and 51.32 ± 2.08 dB(A) in the LN group, with a significant difference (P < 0.001). The HN group exhibited significantly higher levels of interleukin-6 (IL-6, P = 0.033), rheumatoid factor (RF, P < 0.001), higher SDS (P = 0.003) and SAS (P = 0.002) scores and more tender joint count (P = 0.014) than the LN group. Correlation analysis showed that DAS28 (r = 0.418), IL-6 (r = 0.143), RF (r = 0.391), SDS (r = 0.210), SAS (r = 0.193), tender joint pain (r = 0.119) and global health (r = 0.146) were positively correlated with noise levels.

HN exposure is associated with increased inflammatory markers, increased psychological distress and worsened health status in patients with RA.